Occupational Therapists Aid in the Act of Everyday Living

The patient was diagnosed with congestive heart failure. She had a strong desire to stay in her own home, but she was going downhill fast. She couldn’t stand up for more than thirty seconds or walk fifteen feet without help. She needed 24-hour a day care. After a stint at a skilled nursing facility she showed a bit of improvement and then, along came Robin Bangle, a home health occupational therapist for Bonner General Health.

“We started working on her getting in and out of bed, and now she can even make it,” Bangle said. “She couldn’t shower, but with grab bars and a bath bench now she can. She can stand for 19 minutes without getting winded and has learned how to conserve energy. She stays alone at night now and only keeps her housekeeper because she likes her. Right now we’re working on the skills needed for her to drive again.”

The American Occupational Therapy Association says that occupational therapy practitioners ask “What matters to you?” not “What’s the matter with you.” Wikipedia says that occupational therapy is the “use of assessment and treatment to develop, recover, or maintain the daily living and work skills of people with a physical, mental or cognitive disorder.”

Whether it be in-home, in-patient or out-patient the occupational therapists at BGH have skills in a wide-variety of specialties all tailored to assist patients in the activities of daily living. Whether it be from an injury or a debilitating disease, occupational therapy can change a “can’t do” into a “can do.”

“At one point we were all generalists,” said Michelle Tucker, BGH Rehabilitation Director who is also an OT. “But we have gravitated to more specialties.”

And, specialties we have. Amanda Black specializes in pediatrics, vision testing, concussion management and cognitive issues. She works in-patient acute care cases. Susan Silberman is a certified hand therapist. She’s the one you’ll contact if you have carpal tunnel syndrome and any of a multitude of other hand flexibility problems – think being able to button your shirt or to tie your shoelaces. Liz Morris also does hand therapy and pairs it with women’s health issues such as pelvic floor rehabilitation.

It’s important to mention here that you do need a primary care provider’s referral for occupational therapy. Your OT will work as a team with your PCP and perhaps a physical therapist and/or a speech therapist and certainly your caregiver and family members to achieve your goals.

“Our job is to evaluate and treat. We’ll recommend therapeutic procedures for the best outcomes. This is a patient-centered approach,” Tucker explained. “If a patient wants to be able to dress by themselves, we determine how to achieve that goal. Can we improve range of motion? Do we need adaptive equipment?

“Perhaps a patient can’t raise their hand high enough to brush the back of their hair. We might provide a long handled brush for them,” she said. “Often people who can’t do for themselves get depressed, they feel useless. We insure that they are contributing to part of the process so they have some control over their abilities.”

Both Tucker and Bangle talked about the importance of patient safety in the home. The OT will evaluate and make recommendations about things as simple as where to or not to place furniture or a throw rug, how to properly use or not use kitchen appliances, etc.

“We do a lot of caregiver and family education,” Tucker said. “For instance, if a patient is in a wheelchair we’ll teach the caregiver how to transfer the patient to the bed; where pillows should be placed to alleviate pain, and so forth.”

From children born with defects to the elderly with cognitive issues, therapy is specific to helping the patient perform the activities of daily living. Some of us take these abilities for granted; others of us need occupational therapists.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 264-4029 or kathyleehubbard@yahoo.com.